MYSTIC HEALTHCARE AND REHABILITATION FACILITY
NPI 1174867113
Clinic/Center - Physical Therapy in Mystic, CT
NPI Status: Active since November 15, 2012
Contact Information
475 HIGH ST
MYSTIC, CT
ZIP 06355
Phone: (860) 536-6070
- Organization
- Clinic/Center
- Physical Therapy
- CLIA Number: 07D0709627
- CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
- CLIA Exp. Date: 08-31-2026
About MYSTIC HEALTHCARE AND REHABILITATION FACILITY
This page provides the complete NPI Profile along with additional information for Mystic Healthcare And Rehabilitation Facility, a provider established in Mystic, Connecticut operating as a Clinic/center, focusing in physical therapy . The healthcare provider is registered in the NPI registry with number 1174867113 assigned on November 2012. The practitioner's primary taxonomy code is 261QP2000X with license number 003480 (CT). The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Ms. Susan Elizabeth Dorman Rpt (Registered Physical Therapist)
- NPI
- 1174867113
- Provider Name
- MYSTIC HEALTHCARE AND REHABILITATION FACILITY
- Entity Type
- Organization
- Location Address
- 475 HIGH ST MYSTIC, CT 06355
- Location Phone
- (860) 536-6070
- Mailing Address
- 475 HIGH ST MYSTIC, CT 06355
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-15-2012
- Last Update Date
- 11-15-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Physical Therapy
- Taxonomy Code
- 261QP2000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 003480
- License State
- CT
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 07D0709627
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- VIKRAM RAO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Mystic Healthcare And Rehabilitation Facility to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1174867113, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174867113, enumerated as an "organization" on November 15, 2012.
The provider is located at 475 HIGH ST MYSTIC, CT 06355 and the phone number is (860) 536-6070.
Clinic/Center with taxonomy code 261QP2000X and a focus in Physical Therapy.
